Haemodynamic and electroencephalograph responses to intubation during induction with propofol or propofol/fentanyl.
OBJECTIVE
To observe the changes in EEG bispectral index (BIS), 95% spectral edge frequency (95% SEF) and median frequency (MF) with haemodynamic changes to intubation during induction with propofol or propofol and 2 micrograms.kg-1 fentanyl i.v.


METHODS
Twenty four ASA I-II patients were randomized to receive either propofol infusion preceded by normal saline (group P, n = 12) or propofol preceded by 2 micrograms.kg-1 fentanyl (group PF, n = 12). Intubation was performed five minutes after maintenance of BIS within 45 +/- 5. EEG and haemodynamic variables were recorded at before induction, and before and after intubation.


RESULTS
Haemodynamic responses to intubation were greater in group P than in group PF (P < 0.05). Postintubation SBP, DBP and HR increased, compared with preinduction values, more in group P than in group PF. Postintubation BIS values increased from 45.5 +/- 3.5 and 44.2 +/- 4.1 to 51.1 +/- 4.1 and 50.9 +/- 5.3 in groups P and PF, respectively, compared with preintubation values. The BIS values were not different between treatment groups before and after intubation, and 95% SEF and MF values did not increase after intubation.


CONCLUSIONS
Fentanyl, 2 micrograms.kg-1 i.v., blunted the haemodynamic responses to intubation, but failed to attenuate the arousal of cerebral cortical activity. The different haemodynamic responses postintubation but similar BIS and 95% SEF changes in the two groups suggest that BIS or 95% SEF cannot predict the haemodynamic responses to intubation during anaesthesia induction with propofol and fentanyl.
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Department of Anaesthesiology, University of Hirosaki, School of Medicine, Japan.
Sakai
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Takahashi
S
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Matsuki
A
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D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D001143:Arousal / Q000187:drug effects / Q000502:physiology; D001364:Awareness / Q000187:drug effects / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D002540:Cerebral Cortex / Q000187:drug effects / Q000502:physiology; D004311:Double-Blind Method; D004569:Electroencephalography / Q000187:drug effects; D005283:Fentanyl / Q000008:administration & dosage*; D005544:Forecasting; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007262:Infusions, Intravenous; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage*; D012815:Signal Processing, Computer-Assisted; D012965:Sodium Chloride
D018686:Anesthetics, Intravenous; D012965:Sodium Chloride; D005283:Fentanyl; D015742:Propofol